Describe one possible objective of a public health organization.

Explain two characteristics of an intrapreneur at HS.

Explain one advantage and one disadvantage for HS of using formative appraisal.

Recommend which of Option 1 and Option 2 HS should implement.

A possible objective of a public health organization – an organization in the public sector owned and controlled by the government – is to provide essential (medical)services to the community either free of charge or at a low or affordable price at the point of consumption.

Accept any other relevant objective.

Candidates are expected to explicitly mention the provision of health care/services, not just refer to a public organization for [2].

Award [1] for identifying an appropriate objective and [1] for an appropriate description up to a maximum of [2].
Do not credit an example.

Possible characteristics of an intrapreneur in HS may include the following:

The main characteristic of an intrapreneur at HS is to work within an established organization and to come up with new, creative and innovative ideas or concepts to reduce the costs of operation in order to adhere to budgetary constraints. The intrapreneurs should enable HS to create a USP and increase its customer base. HS is known for its creativity, hence indication of the success of the consultants as intrapreneurs for HS.

A consultant, intrapreneur, does not risk his/her own capital in case of failure but takes risk for the organization for which he or she works. Nor does he or she come up with a new business venture, but the characteristic is to demonstrate the same traits of an entrepreneur, like being an independent thinker, proactive, flexible, innovative, turning ideas/projects into a profitable medical service for an organization within which he or she works, in this case, HS while working for an existing organization.

Accept any other relevant/applicable role.
Please note: For full marks the candidates should demonstrate an intrapreneur is an employees / works in a business otherwise some of the characteristics like risk taking, could be equally applicable to an entrepreneur.

Mark as 2 + 2.

Award [1] for each relevant characteristic explained and [1] for appropriate application to HS to a maximum of [2].

[2] cannot be awarded for each reason used if the response lacks either explanation and / or application.
For example:
For an identification or a description of a characteristic with or without application [1].
For explanation of a characteristic with no application [1].
For explanation of a characteristic and application [2].

Do not penalise candidates for not defining or describing formative appraisal. However, the explanation must show understanding of the nature of this type of appraisal as specified below or the difference between formative and summative.

The possible advantages for HS of using formative appraisal:

As an ongoing, continuous process of appraisal, the management of HS provides monthly feedback for consultants regarding their performance. Constant and regular feedback can be highly rewarding / motivating when good performance is commented on and some weaknesses can be improved with constructive feedback. As HS expects the consultant to be creative and ready to let them take a risk, one may argue that constant formative appraisal can be very effective in terms of identification of strengths and weaknesses of individual consultants and adjustment can often/frequently be made before major and costly problems occur. HS is therefore reducing the risk of failure as well as increasing motivation of its employees.

Accept any other relevant / applicable advantage.
Do not credit a statement on improving performance unless it is connected to the issue of formative/ on- going/ frequent / continuous feedback. Needs a reference to a time frame.

The possible disadvantages for HS of using formative appraisal:

Consultants may feel stressed, especially as they are likely to be highly skilled and possess the main characteristics of an intrapreneur.
Formative appraisal, especially as it is done monthly, might take unnecessary time/resources/money and interrupt the consultant as well as the management work. Inefficiency and demotivation may emerge as consultants may feel that there is some inconsistency between the expectation to be intrapreneurs and constant monitoring.
Projects may take longer than one month to carry out; constant monitoring might reduce the efficiency and quality of the service and stifle the much-needed creativity.

Accept any other relevant / applicable disadvantage.
It is not expected that the response will be as detailed as above but should cover the main issues.

N.B. Candidates should refer to and show understanding of formative appraisal, not just appraisal.

Mark as 2 + 2.

Award [1] for each relevant advantage/disadvantage explained and [1] for appropriate application to HS to a maximum of [2].

[2] cannot be awarded for each reason used if the response lacks either explanation and / or application.
For example:
For an identification or a description of an advantage/ disadvantage with or without application [1].
For explanation of an advantage/ disadvantage with no application [1].
For explanation of an advantage/ disadvantage and application [2].

Possible arguments for HS setting up a charity to create educational services to children with long-term health problems:

• Dan’s suggestion fits the nature of the work that the consultancy actually does. A synergy can be created between HS and HSE.
• HS can successfully market their ethical behaviour and their CSR, especially given that their consultants will visit the sick children and get personally involved. Moreover, the creation of the HSE name can further enhance HS’s brand image. Despite short-term costs of setting up the charity and the injection of part of the profit into it, in the medium to long term, HS’s brand image may be enhanced. Public support, recognition, trust and the demand for its services may rise. Profit may be the reward and opposition to the high fees will be reduced. One may judge this argument as highly significant as currently there is a public outcry about the fees the consultants are paid by a public sector organization.
• HSE should be able to claim some tax exemption, but this argument cannot be judged as a significant one.

Possible arguments against HS setting up a charity to create educational services to children with long-term health problems:

• Some hospital managers/potential clients may look at the suggestion as a cynical attempt to raise publicity and increase profit. Setting up a charity might not outweigh the negative perception of HS due to the high price it charges public hospitals and the drain on the hospitals’ budget that could have been spent on sick patients.
• Internal conflict may arise within HS. The employees might feel obliged and perhaps overworked. Their much-needed creativity/intrapreneurial spirit may be damaged as demotivation sets in.
• Some of the shareholders with the short-term view of receiving dividends may object to the use of part of HS’s retained profit as funds for the charity.
• Candidates might use other textbook disadvantages like inefficiencies, fraud and disincentive effects due to a lack of profit.

Accept any other relevant argument for or against.

Given the above, perhaps Lauren’s suggestion that reducing the high fees should be the priority.

HS will still use the talent/skills of its employees/project teams to develop new untested software to significantly reduce the costs of operation; in turn HS could charge public sector hospitals a lower fee. Still, the lower fees might still be perceived as high or unjustified by the pressure groups protesting against the high fees charged by HS.
However, this solution may be judged as a sustainable one as the use of public money on software to improve the hospital efficiency and keeping the hospital budget on target might be judged as a worthwhile expenditure.

Although the development of the software is likely to incur time and costs for HS in the short run, the challenge might further motivate the consultants and complement or even enhance the intrapreneurial spirit that already exists.

Being able to charge the hospital lower fees can be seen as a long-term competitive advantage and will be more likely to pacify the pressure group as it directly addresses the issue the pressure groups complained about. Creating a charity, while likely to be generally welcome, might not reduce the pressure from the pressure group if fees remain high.

However, the process might be long and very expensive and the software is untested. Is there a contingency plan if the tests do not lead to the benefits claimed?

Accept any other relevant argument for or against.

Conclusions/judgment:
It appears that venturing into the creation of a charity may take HS away from its core competency and there are more significant arguments against. Using its core competency and the talent of the consultants to create software will enhance creativity and motivation as well as directly address the concern of the pressure group and hospital manager and it will benefit more stakeholders.

It is expected that candidates provide a conclusion with a substantiated judgment.

Candidates can provide any conclusion and judgment as long as it is substantiated.

Accept any other substantiated judgment.

Examiners’ judgment should be based not just on the number of the arguments in terms of balance but on the quality/ clarity /relevance of the argument.

Marks should be allocated according to the Paper 2 markbands for May 2016 forward.

For one relevant issue that is one-sided, award up to [3]. For more than one relevant issue that is one-sided, award up to a maximum of [4].

If a candidate evaluates / addresses only one option in a balanced manner award a maximum of [5].

A balanced response is one that provides at least one argument for and one argument against each option.

Award a maximum of [6] if the answer is of a standard that shows balanced analysis and understanding throughout the response with reference to the stimulus material but there is no judgment/conclusion.

Candidates cannot reach the [7–8] markband if they give judgment/conclusions that are not based on analysis/explanation already given in their answer.

This question was largely well answered. However, some candidates referred to HS as a public organisation and consequently assumed that one possible objective was to help customers to budget.

Some good and applicable responses were evident. However, many candidates lost marks mainly due to a lack of application, and the description rather than the explanation of a specific characteristic. For example, it was not sufficient to write that an intrapreneur is a risk taker. It was expected that the candidates explain that no personal risk or own capital risk is involved.

It was very disappointing to see that the majority of candidates did not produce relevant and accurate responses. All too often zero marks were awarded. This topic was tested for the first time during this examination session. Candidates referred to formal appraisal, informative appraisal or just appraisal.

Only a small number of candidates demonstrated understanding of the continuous, ongoing, constant nature of the appraisal process and the nature of the process in order to identify strengths and weaknesses regularly and to take action.

Needless to say that candidates who did not understand the nature of formative as opposed to the summative appraisal process, did not apply the stimulus well.

Many candidates demonstrated a good understanding the suggested options that HS can use. It was pleasing to see candidates present balanced responses which applied the stimulus. Nevertheless, a significant number of candidates were not able to reach the two highest markbands due to:

• Repeating the same information from the stimulus with little or often no full explanation as to why the arguments are a positive or negative argument.

• Not going beyond the ideas or information presented in the stimulus.

• A nominal conclusion presented as a summary of points or issues for and against the methods without substantiation

Please note that substantiation of the arguments and the significance of the arguments presented in relation to the organisation, different stakeholders, short term impact as opposed to the long term impact should be evident throughout the response or towards the end.